How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $436.52 | Professional | None | $245.47 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $7,762.47 Typical High $11,220.18 | Facility | None | $4,365.16 | $7,762.47 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $707.95 | Professional | None | $331.13 | $575.44 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $1,148.15 | Professional | None | $239.88 | $354.81 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $1,174.90 Typical High $12,589.25 | Facility | None | $331.13 | $1,174.90 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,905.46 | Professional | None | $302.00 | $562.34 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | None | $575.44 | $575.44 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $4,365.16 Median $7,762.47 Typical High $11,220.18 | Facility | None | $4,365.16 | $7,762.47 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $794.33 | Professional | None | $457.09 | $660.69 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $537.03 | Professional | None | $234.42 | $436.52 | $537.03 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $15,848.93 | Facility | None | $724.44 | $3,090.30 | $15,848.93 |
United Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $724.44 | Professional | None | $275.42 | $398.11 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | None | $501.19 | $501.19 | $562.34 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $120.23 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $48.98 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $181.97 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.99 | $43.65 | $43.65 |
Where Iowa sits
The same service costs 4.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Iowa· 6th of 51
$562
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.